Hospitals with certain characteristics found more likely to achieve cost savings through CJR

March 14, 2018

Larger hospitals and hospitals with non-profit or teaching status appear to yield greater cost savings through the Comprehensive Care for Joint Replacement program, according to results published in JAMA.

To identify and describe the proportion, distribution and quality performance of the Comprehensive Care for Joint Replacement (CJR) hospitals that achieved episode savings, Amol S. Navathe, MD, PhD, and colleagues used Medicare data from April 2016 to March 2017, also known as performance year 1.

Amol S. Navathe

Of the 799 hospitals that participated in the CJR in the first year, results showed 48% were savings hospitals. Researchers found a variation in mean episode savings from $13.83 to $3,590.97, and good or exceptional quality among 351 hospitals.

Savings hospitals were larger and had higher volume. These were also more likely to be nonprofit, teaching and integrated with a post-acute care facility compared with non-savings hospitals. Researchers noted low-volume and safety-net hospitals were more likely to be non-savings hospitals. Although savings and non-savings hospitals had similar baseline quality, results showed lower baseline spending among savings hospitals.

“The first year of mandatory joint replacement bundled payment seems quite successful overall, since about half of hospitals achieved financial savings while hitting quality benchmarks. That is a high proportion of successful hospitals compared to other Medicare value-based programs,” Navathe told Healio.com/Orthopedics. “Though it does not mean there were not concerns around the results, like the small number of low-volume hospitals or safety net hospitals that achieved savings.” – by Casey Tingle

Disclosure: Navathe reports he receives grant funding from the Hawaii Medical Services Association and Oscar Health Insurance; serves as advisor to Navvis, Navigant, Lynx Medical, Indegene and Sutherland Global Services; and receives an honorarium from Elsevier Press. Please see the full study for a list of all other authors’ relevant financial disclosures.

Larger hospitals and hospitals with non-profit or teaching status appear to yield greater cost savings through the Comprehensive Care for Joint Replacement program, according to results published in JAMA.

To identify and describe the proportion, distribution and quality performance of the Comprehensive Care for Joint Replacement (CJR) hospitals that achieved episode savings, Amol S. Navathe, MD, PhD, and colleagues used Medicare data from April 2016 to March 2017, also known as performance year 1.

Amol S. Navathe

Of the 799 hospitals that participated in the CJR in the first year, results showed 48% were savings hospitals. Researchers found a variation in mean episode savings from $13.83 to $3,590.97, and good or exceptional quality among 351 hospitals.

Savings hospitals were larger and had higher volume. These were also more likely to be nonprofit, teaching and integrated with a post-acute care facility compared with non-savings hospitals. Researchers noted low-volume and safety-net hospitals were more likely to be non-savings hospitals. Although savings and non-savings hospitals had similar baseline quality, results showed lower baseline spending among savings hospitals.

“The first year of mandatory joint replacement bundled payment seems quite successful overall, since about half of hospitals achieved financial savings while hitting quality benchmarks. That is a high proportion of successful hospitals compared to other Medicare value-based programs,” Navathe told Healio.com/Orthopedics. “Though it does not mean there were not concerns around the results, like the small number of low-volume hospitals or safety net hospitals that achieved savings.” – by Casey Tingle

Disclosure: Navathe reports he receives grant funding from the Hawaii Medical Services Association and Oscar Health Insurance; serves as advisor to Navvis, Navigant, Lynx Medical, Indegene and Sutherland Global Services; and receives an honorarium from Elsevier Press. Please see the full study for a list of all other authors’ relevant financial disclosures.